It is difficult to be faced with theses circumstances and my heart goes out to you both. I trust she is receiving advice and treatment from a team of specialists, including an oncologist and breast surgeon, and you and she might also benefit from attending a support group.
Breast cancer occurs in 1 in 68 women in the range of 40 - 49. It occurs even more frequently as we age, and the lifetime risk is approximately 1 in 8. It is the most common cancer of women but is NOT the most frequent cancer associated death (actually lung cancer is the most frequent cause of cancer related death in women.)
So what does it mean that she was diagnosed at Stage 2? Tumors are assigned a stage according to their size at the time of diagnosis and whether there is evidence of having spread (metastasized) to surrounding and distant sites in the body. A stage 1 tumor is localized to the breast and is less than 2 cm (about 1 inch) in size. A stage 2 tumor is at least 2 cm and may have spread to the lymph nodes that drain the affected breast. Stage 3 tumors are 5cm or larger and/or have spread locally and stage 4 tumors have spread to distant sites, at the time of diagnosis.
As far as how well a person will do in treatment, the stage of the tumor helps to predict, but the specific cellular characteristics of the tumor also have a role in determining what the appropriate treatments might be and how well they might work. For example, some tumors have estrogen or progesterone receptors on the surface of the cells that allow these hormones to fuel their growth. Treatment will be directed toward blocking these hormones. Some tumors have a cellular protein referred to as HER-2 which actually accelerates their growth so an agent that blocks this protein, a monoclonal antibody, is used to treat these tumors.
Some tumors are lacking all of these characteristics and they may be more aggressive tumors, known as "triple negative breast tumors. They are rare, but there is a higher incidence in premenopausal African Americans and Latinas. If a tumor is more aggressive it will grow faster during the interval between mammograms and this may be why your partner's tumor was diagnosed at stage 2. Another possibility is that her breasts are very dense and the mammogram did not pick an abnormality until this year for that reason.
Currently we recommend that women begin yearly mammography screening at age 40 or 10 years before the age at which a first degree relative was diagnosed (i.e. mother or sister) which ever comes first. Most women with breast cancer do NOT have a family history of this disease and in fact only 30% of women diagnosed with breast cancer actually do have a family history.
We don't recommend screening younger women because breast cancer is rarer and the increased density of the breasts of younger women interferes with the interpretation of the results. Ultrasound is useful to distinguish solid tissue from a fluid filled cyst when a lump or mammographic shadow is found, but is not a way to screen for cancer in someone with no symptoms. MRI has a host of problems as a screening tool and it isn't clear yet whether this will be better than mammogram.
There are currently no specific tumor markers in the blood that can be screened for.
So what we do recommend is beginning yearly mammograms at age 40 or earlier if there is a family history that mandates this, combined with a yearly breast exam by your primary doctor, and occasional self exams. This way, if a tumor does develop it is likely to be diagnosed at an early stage. This seems to be exactly what you and she were doing, and so the short answer to your question is: no, there was no other screening that you should have been doing. Ask your doctor to discuss your risk factors with you, which may include, use of hormones, alcohol consumption above one drink per day, obesity, and exposure to radiation. There are also risk factors you cannot change such as age of your first period, your first pregnancy, number of pregnancies, whether you breastfed, age of menopause, and family history. Get plenty of exercise, eat a good diet, drink clean water, and keep your weight down.
Download a fact sheet on breast cancer screening
Additional web sites you may want to check out are the Massachusetts Breast Cancer Coalition www.mbcc.org which provides up to date information including information on environmental pollutants that may be contributing to the increasing breast cancer rate, and Dr. Susan Love's site www.dslrf.org which keeps you abreast of the research on diagnosis and treatment.
